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Lots of questions: supply, milk production, night feeding

So one question comes from a slight concern, the others are just "wonderings" I've developed.

The concern: I called our local hospital's breastfeeding help line to ask something, and the LC expressed surprise that my milk supply seems to be adequate despite hour long feedings on one breast. She said something about efficient suck and supply.

I thought that demand influences supply, and since he's demanding it 10+ hours a day, I figured my supply was great. (note: I've never noticed a short supply)

And now the wondering: From reading different things here, I've gotten the sense that as a baby grows, his intake amount stays relatively the same, but the nutrient/satiety level of the milk changes to meet his growth? Is this accurate? If so, that's awesome!

And the last questions: At night, my son sometimes sleeps 3 hours and sometimes up to 6 before wanting to eat again. Does my body just somehow "know" that his feeding is so irregular and my milk supply stays just fine?

Re: Lots of questions: supply, milk production, night feedin

I can understand your LC's surprise. Very long feedings are sometimes very inefficient feedings- the baby's latch isn't right or the baby is so sleepy that it takes her f.o.r.e.v.e.r to get a full meal. The "sometimes" part of that statement is why feeding speed is such a misleading indicator of how breastfeeding is going. Some babies get full meals in just 5-10 minutes, others take the classic 10 minutes per breast, and others will feed closer to an hour.

If you need to know how breastfeeding is going, the important things are a) how nursing feels, b) diaper output, and c) growth. When nursing feels okay and baby is producing adequate wet and poopy diapers and is growing normally, there's no reason to worry.

Are you currently offering just one breast per feeding? And if so, why? If the reason is oversupply and fast letdowns, one sided feeding may be advisable. But thee are lots of other reasons why moms do one-sided feedings, and it isn't always what they want to be doing. In particular, if your baby is feeding for an hour at a time, offering both breasts at a feeding may speed things up a bit.

It is true that a baby's milk volume needs don't change much as time goes on. This can be really surprising when you consider that formula-fed babies consume larger and larger amounts of formula as time goes on! But breastmilk does seem to become more calorie dense with time, and because breastfed babies tend to be good self-regulators in terms of intake, they generally don't want more and more milk as time goes on.

Don't worry about sleep too much. Your body has a very sensitive internal clock that can be trained to make the right amount of milk for a given time of day- more when more is required, less when it's not. If a baby wakes to feed ahead of his usual wake-up time, he will nurse and encourage mom's body to make a little more for that time of day. If he sleeps through his usual wake-up time, the lack of demand will encourage mom's body to throttle production back a bit.

How old is your LO? With very young babies (<6 weeks) it's often best to wake them before 6 hours has gone by. And it's worth noting that when a baby goes 6 or more hours without nursing, breastfeeding will not provide reliable protection against pregnancy. So make sure you have your birth control choices lined up!

Re: Lots of questions: supply, milk production, night feedin

Well, the one sided thing just kinda happened. I started realizing he was nursing longer and longer on just one side after his 5 week growth spurt. Before that he would nurse 30 min or so on each side. Since he stays on without coming off on his own, I just let him nurse until he does. And that's how we got to 45 min - 1hr.

I do think he has an upper lip tie, and can't flange his upper lip. He just doesn't flange his lower lip- i think because of suction problems? We see an ent tomorrow.

He is 10 weeks, and it took 6 years to get pregnant with our son, so another so soon would be fine-though highly unlikely given our situation.

Re: Lots of questions: supply, milk production, night feedin

I called our local hospital's breastfeeding help line to ask something, and the LC expressed surprise that my milk supply seems to be adequate despite hour long feedings on one breast. She said something about efficient suck and supply.

it depends on the helpline, but most hospitals i know of who offer a lactation helpline do not pay a board certified lactation consultant just to take help calls. If they employ one at all, that ibclc is USUALLY busy with in person appointments. Many hospitals staff helplines with advice nurses who may or may not have clinical breastfeeding experience helping moms or be board certified.

To say a mothers milk supply is low because baby nurses a long time is kind of backwards. Long nursing sessions are one sign of possible poor milk transfer, which may or may not be related to low supply. In other words, something to be aware of but not enough info to diagnose any problem. Some babies just really enjoy nursing and will hang out a long time. I agree with mommal, switching sides could help baby move on abit faster, as could breast compressions, and of course lip tie is potentally a factor in poor milk transfer. But even if baby HAS a milk transfer issue, youi may have kept that from becoming a supply issue-by cue nursing and nursing for long periods.

I assume baby is gaining appropriately on breastfeeding alone, if that is the case, you do not currently have a low supply issue.